In the middle of the eleventh century, icons executed in fresco-technique and depicting important arch-priests of the church were painted on the walls of the icon and proskomide in the cathedral church of St. Sophia in Ohrid. Among these, the best preserved are the half-length portraits of the Patriarchs of Alexandria, John and Eustathius, and the figures of St. Polycarp and Timothy. The anonymous painter took pains that these icons should give the impression of having been painted on wood. He especially stresses the plasticity of the material the icons are painted on, bringing out the depth of the coffer with the use of shadows; he also painted the metal hangers and nails with which those 'wooden' icons were 'hung' on the walls in the church. Among the best-preserved figures are those of St. Cyrus and St. John. In some miniatures, such as a miniature in the Psalter of 1066 in the British Museum, we find the same endeavour to depict icons as being 'hooked' and 'hanging' on church walls.

In the churches of this and later periods, besides frescoes 'hung' on walls we can find fresco-icons linked to the iconography of the iconostasis. When discussing the church of St. Sophia in Ohrid, special attention should be drawn to the fresco-icons painted on the columns at the level of the iconostasis. There are two large fresco-icons dedicated to the Mother of God with the Infant Jesus in her arms, that on the north column being of the type of the Mother of God of Sorrows.

Fresco-icons cannot be discussed without mention of those painted in the church of St. Panteleimon at Nerezi, near Skopje, dating from 1164. Here, as in the church of St. Sophia in Ohrid, there are two types of icons: those 'hung' on the walls and those 'framed' on the columns framing the iconostasis. The icons 'hung' on the walls of the church of St. Panteleimon, Nerezi, are to be found in the north chapel and in the proskomide, while the frescoes painted on pillars, with rich stucco-work frames, form a whole together with the iconostasis.

Such fresco-icons decorated with rich marble or stucco-work frames are to be found in the church of the Mother of God Kyriotisa in Constantinople, late eleventh century, in the church of the Mother of God in Samara in the Peloponnese, late twelfth century, and others. When the donors were unable to afford more expensive frames, the painters were obliged to paint frames themselves for these icons, as was the case with the fresco-icons on the north and south walls on either side of the iconostasis in the church of St. George, Kurbinovo, dating from 1191, or in the church of St. John the Divine at Kaneo in Ohrid, dating from the closing years of the thirteenth century. It can be assumed with considerable certainty that such fresco-icons were painted on the columns of either side of the marble iconostasis in the church of the Mother of God Peribleptos (St. Clement's) in Ohrid in 1295. However, these were destroyed during the installation of the new wooden iconostasis made by the woodcarver Toma and painted by Dico Zograf in the nineteenth century.

In 1317 the well-known medieval painters Michael and Eutychios painted fresco-icons dedicated to the patron saint of the church, St. George, and to the Mother of God Pelagonitisa on the surfaces created in the iconostasis after the walling up of the intercolumnar spaces. Some years later, they painted the fresco-icon dedicated to St. Nicetas in the church of the same name in the village of Banjani, near Skopje. There are in existence numerous fresco-icons which were painted in the churches of Macedonia from the eleventh up to the close of the fifteenth centuries.

All these fresco-icons indicate that fresco-painting was inextricably linked to easel painting and that icons done in tempera on wood were the products of the same painters or painting workshops. But there are cases where some painters are more closely connected with icon-painting on wood, which may be considered as a more specialised branch in the field of painting. If one looks closely at them, their works indicate a tendency towards the more precise modelling which easel painting demands.

A study of the development of medieval icon-painting in Macedonia, especially the icons done in tempera on wood, is made possible by the existence of a number of icons dating from the eleventh century. Starting out from them, the oldest icons known to date, we can distinguish four groups on the basis of the time at which they were executed:

- Icons from the time when Macedonia was under Romaoian rule and up to the time when it came under the medieval Serbian state;

- Icons dating from the period when Macedonia was under medieval Serbian rule;

- Icons dating from the period up to the close of the 17th century when Macedonia was under the dominance of the Ottoman Turks;

- Icons dating from the period of the 18th century renaissance and up to the collapse of the Ottoman Turkish Empire in 1912.